Laryngeal cleft: A literature review

Area of Science:

• Pediatric Otolaryngology
• Congenital Airway Anomalies
• Surgical Innovation

Background:

• Laryngeal clefts are congenital airway malformations causing aspiration and feeding difficulties.
• Increased survival rates for neonates with laryngeal clefts shift focus to treatment and management.
• The Benjamin-Inglis system classifies laryngeal cleft severity.

Purpose of the Study:

• To review current management strategies for laryngeal clefts.
• To analyze post-operative outcomes of various laryngeal cleft treatments.
• To understand the impact of comorbidities on laryngeal cleft patient outcomes.

Main Methods:

• Comprehensive literature review of laryngeal cleft studies published between 2010 and 2021.
• Analysis of 1033 patient cases, with detailed classification data for 415.
• Evaluation of treatment approaches based on laryngeal cleft type and severity.

Main Results:

• Swallowing dysfunction is primary in types I, III, and IV; stridor and aspiration in type II.
• Comorbidities negatively impact clinical outcomes in laryngeal cleft patients.
• Successful conservative treatment for 19% of type I clefts; surgical management for most.
• High success rates for injection laryngoplasty in type I clefts.
• Endoscopic repair used for 98% of type II, 87% of type III, and open surgery for 66% of type IV clefts.
• Cases resolved within 12 months; failed cases often within 6 weeks.

Conclusions:

• Treatment selection for laryngeal clefts depends on type, severity, and comorbidities.
• Conservative management suits mild symptoms or type I clefts; surgery is an option for all types.
• Injection laryngoplasty and endoscopic repair are common surgical techniques.
• Open surgery is reserved for severe laryngeal clefts or when other methods are unsafe.
• Understanding clinical characteristics guides management and improves outcomes for laryngeal clefts.